Healthcare Provider Details

I. General information

NPI: 1770651697
Provider Name (Legal Business Name): HUAN QUANG VU D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10512 BOLSA AVENUE STE 101
WESTMINSTER CA
92683-6727
US

IV. Provider business mailing address

10512 BOLSA AVE STE 101
WESTMINSTER CA
92683-6727
US

V. Phone/Fax

Practice location:
  • Phone: 714-554-8784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number20023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: